Objectives: Thoracoscopic management of mediastinal
tumors is still subject to analysis. Seventy-three patients underwent
thoracoscopy for treatment of mediastinal masses and were analyzed
retrospectively in order to evaluate the effectiveness and
complications of the procedure.
Methods: Between 1983
and 1999, 21 conventional thoracoscopies and 52 video-assisted thoracic
surgeries were performed (33 for diagnostic purposes and 40 for
therapy). Patient ages ranged from 2 to 81 years (mean, 43.8 years)
with a slight predominance of girls and women over men and boys (41 vs
32, respectively). All patients underwent general anesthesia using
simple intubation (22 patients) or double-lumen intubation (51
Results: The histologic type of tumors was
obtained in all patients. For therapeutic purposes, a change of
procedure to thoracotomy was necessary in nine patients. The reasons
for this change were tumor size, tumor invasion of nearby structures,
difficulties in continuing the dissection, the performance of an upper
lobectomy, and suturing the iatrogenic lesion of the diaphragm. Four
patients died during the first 30 postoperative days as a consequence
of their primary pathology.
was confirmed as an effective diagnostic and therapeutic alternative
for the treatment of mediastinal disorders.